CAROLINA NICOLETTI FERREIRA FINO
Projetos de Pesquisa
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LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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- Food and Nutrition Public Policies in Brazil: From Malnutrition to Obesity(2022) WATANABE, Ligia Moriguchi; DELFINO, Heitor Bernardes Pereira; PINHEL, Marcela Augusta de Souza; NORONHA, Natalia Yumi; DIANI, Luisa Maria; ASSUMPCAO, Lucca Cintra do Prado; NICOLETTI, Carolina Ferreira; NONINO, Carla BarbosaNutrition transition describes the shifts in dietary consumption and energy expenditure influenced by economic, demographic, and epidemiological changes at a population level. This phenomenon has been associated with rising obesity rates worldwide, especially in developed countries. In Brazil, the historical analysis of temporal trends between malnutrition and obesity characterized the nutrition transition in the country and interweaved it with the formulation and implementation of public food and nutrition policies. Such analysis is crucial for understanding certain principles in each context. Thus, this review contextualized the consolidation of obesity as a critical health and public policy issue in Brazil. Our review suggested that the country may still be at the initial stage of care for obesity, and more efforts are needed to contain the advance of the disease in Brazil.
- Impact of methyl-donor micronutrient supplementation on DNA methylation patterns: A systematic review and meta-analysis of in vitro, animal and human studies(2023) MOTA, Jhulia Caroline da; RIBEIRO, Amanda A.; CARVALHO, Lucas M.; ESTEVES, Gabriel P.; SIECZKOWSKA, Sofia M.; GOESSLER, Karla F.; GUALANO, Bruno; NICOLETTI, Carolina F.Background: DNA methylation patterns are directly associated with diverse metabolic disorders. The status of methyl-donor micronutrients has been associated with DNA methylation levels, and altered ingestion of folate, choline, betaine, B vitamins and methionine may impact genes both globally and at the level of promoter regions. Despite this, the role of methyl-donor micronutrient supplementation on DNA methylation profiles is currently unclear. Objectives: The aims of this systematic review and meta-analysis were to identify and synthesize the evidence about methyl-donor nutrients supplementation on DNA methylation profile. Methods: A systematic literature search was performed in MEDLINE, EMBASE, SCOPUS and Web of Sciences databases with a combination of terms related to DNA methylation assessment, supplementation and methyl-donor nutrients. Studies (in vitro, animal models or human clinical trials) were included if DNA methylation levels after any kind of methyl-donor micronutrient supplementation or treatment was investigated. Studies were assessed for bias using Revised Cochrane risk-of-bias tool for randomized trials, Risk Of Bias in Non-randomized Studies of Interventions or Systematic Review Centre for Laboratory Animal Experimentation tools. Data was extracted from studies measuring DNA methylation level in any sample or tissue, following any kind of methyl-donor micronutrient supplementation or treatment. Separate random-effects meta-analyses were performed for animal model studies and human clinical trials, which examined the effects of folic acid supplementation on DNA methylation. Results: Fifty-seven studies were included in the systematic review: 18 human clinical trials, 35 in animal model and 4 in vitro studies. Concerning overall risk of bias, most of the studies were classified as ""high risk"" or ""some concerns"". Meta-analysis with meta-regression from studies in animal models showed that folic acid dose significantly affected DNA methylation and that high and very high dose showed increases in DNA methylation when compared to low doses. However, meta-analysis from human clinical trials showed that folic acid supplementation did not promote significant changes in DNA methylation when compared to placebo. Conclusion: Folic acid supplementation may change global DNA methylation levels in animals supplemented with high, as compared to low, doses. Heterogeneity in studies and supplementation protocols make it difficult to establish clinical recommendations. However, these effects, even if small, might be of clinical importance in the management of patients with diseases related to DNA hypomethylation.
- Maternal plasma transforming growth factor-b1 (TGF-b1) and newborn size: the Araraquara Cohort Study(2023) DEJANI, Naiara Naiana; NICOLETTI, Carolina F.; ARGENTATO, Perla Pizzi; PEREIRA, Ludmilla da Silva; SARAIVA, Amanda Correia; ASSIS, Leticia Montanha de; NAKANDAKARE, Patricia Yury; BATISTA, Livia Patricia Rodrigues; TELES, Laisla de Franca da Silva; LEITAO, Maria Paula; LUZIA, Liania Alves; MEDEIROS, Alexandra Ivo de; RONDO, Patricia HelenObjective: To investigate associations of maternal and cord blood cytokine patterns with new-born size and body composition. Methods: This cross-sectional study involved 70 pregnant women and their healthy newborns selected from the ""Araraquara Cohort Study"". Newborn anthropometric measurements were recorded at birth. Body composition was evaluated by air displacement plethysmography. Mater -nal blood samples were collected from pregnant women between 30 and 36 weeks of gestation, and umbilical cord blood samples were collected immediately after placenta discharge. The con-centrations of the cytokines were determined in plasma by ELISA. Multiple linear regression mod -els were used to assess associations between maternal and cord blood cytokine concentrations and newborn anthropometry and body composition measurements. Results: Maternal plasma TGF-fi1 concentration was inversely associated with newborn weight (fi =-43.0; p = 0.012), length (fi =-0.16, p = 0.028), head circumference (fi =-0.13, p = 0.004), ponderal index (fi =-0.32, p = 0.011) and fat-free mass (fi =-0.05, p = 0.005). However, the asso-ciation persisted just for head circumference (fi =-0.26; p = 0.030) and ponderal index (fi = - 0.28; p = 0.028), after adjusting for pre-gestational BMI, gestational weight gain, gestational age, hours after delivery, newborn sex, smoking and alcohol consumption. Conclusions: Maternal plasma TGF-b1 concentration may be involved in the regulation of new-born size, mainly head circumference and ponderal index. Further cohort studies are necessary to investigate the role of TGF-b1 in different trimesters of pregnancy and its effect during the early stages of fetal development. (c) 2022 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Pediatria. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).
- Nutritional Inadequacies Among Post-bariatric Patients During COVID-19 Quarantine in Sao Paulo, Brazil(2021) NICOLETTI, Carolina Ferreira; ESTEVES, Gabriel Perri; GENARIO, Rafael; SANTO, Marco Aurelio; CLEVA, Roberto de; GUALANO, Bruno; ROSCHEL, HamiltonPost bariatric control of food intake is influenced by psychological and behavioral factors. We investigated dietary habits and food intake during COVID-19 quarantine among recently operated patients. Patients were assessed for total and per meal energy and macronutrient intake as well as frequency of food consumption per processing level. Patients were also classified according to adherence to nutritional recommendations from our outpatient clinic. Main results are indicative of inappropriate nutritional intake during COVID-19 quarantine in postoperative bariatric patients. We observed that many patients failed to meet the recommended protein intake (89.2%) along a relatively high intake of ultra-processed foods (similar to 1/4 of the diet). Our data suggest the need for the implementation of strategies to extend nutritional care to at-risk patients during social distancing.
- Nutritional therapy for hospitalized patients with COVID-19: A narrative and integrative review(2022) GRECCO, B. H.; ARAúJO-ROSSI, P. A. O.; NICOLETTI, C. F.Hospitalized patients affected by coronavirus disease 19 (COVID-19) have a sustained pro-inflammatory state and recurrent gastrointestinal symptoms that correlate with a decline in the nutritional status, which is directly related to poor immune response and clinical evolution. Nutritional therapy has proven crucial in COVID-19 treatment through the provision of adequate amounts of nutrients. Since the beginning of the pandemic, medical societies have mobilized to provide practical nutritional guidelines to support decision-making; despite this, there are only a few studies dedicated to compiling the most relevant recommendations. In this narrative review, we aimed to summarize and stratify the current scientific literature on nutritional support for hospitalized COVID-19 patients. We carried out a literature review from three databases between January 2020 and July 2021, using nutrition therapy (or medical nutrition or enteral nutrition or parental nutrition or nutritional support) and COVID-19 (SARS-CoV-2 infection) as the search terms. Only those studies that evaluated adult hospitalized patients with admissions to wards, specific clinics, or intensive care units were included. The nutritional intervention considered was that of specific nutritional support via oral, enteral, or parenteral modes. A total of 37 articles were included. In general, the nutritional care provided to COVID-19 patients follows the same premises as for other patients, i.e., it opts for the most physiological route and meets nutritional demands based on the clinical condition. However, some protocols that minimize the risk of contamination exposure for the health team have to be considered. Energy requirements varied from 15 kcal/kg/day to 30 kcal/kg/day and protein goals from 1.2 g/kg/day to 2 g/kg/day. In both cases, the ramp protocol for increased supply should be considered. In cases of enteral therapy, ready-to-use diet and continuous mode are recommended. Attention to refeeding syndrome is essential when parenteral nutrition is used. © 2022
- Poor Eating Habits and Selected Determinants of Food Choice Were Associated With Ultraprocessed Food Consumption in Brazilian Women During the COVID-19 Pandemic(2021) SMAIRA, Fabiana Infante; MAZZOLANI, Bruna Caruso; ESTEVES, Gabriel Perri; ANDRE, Heloisa C. Santo; AMARANTE, Milla Cordeiro; CASTANHO, Daniela Fernandes; CAMPOS, Karen Jennifer de; BENATTI, Fabiana Braga; PINTO, Ana Jessica; ROSCHEL, Hamilton; GUALANO, Bruno; NICOLETTI, Carolina FerreiraBackground: The aim of this study was to investigate possible associations between food consumption and eating habits and food choice determinants in women during COVID-19 pandemic. Methods: This is a cross-sectional survey conducted in Brazil between June and September, 2020, during which time social distancing measures were in place. Results: Participants (n = 629) were aged 34.0 years and mostly within normal weight according to BMI (60.4%). ""Snacking"" and ""liking"" associated with increased energy (beta = 164.27 and beta = 110.24) and carbohydrate intake (beta = 1.97 and beta = 1.80), and with reduced protein intake (beta = -1.54 and beta = -1.18). In contrast, ""dieting"" and ""weight control"" associated with reduced energy (beta = -162.57 and beta = -111.49) and carbohydrate intake (beta = -2.78 and beta = -2.07), and with increased protein intake (beta = 3.78 and beta = 1.65). ""Dieting"" (beta = 7.27), ""need and hunger"" (beta = 3.34), and ""health"" (beta = 4.94) associated with an increased consumption of unprocessed and minimally processed foods, whereas ""replacing main meals with snacks"" (beta = -8.98), ""snacking"" (beta = -6.92) and binge eating symptoms (beta = -0.34) associated with reduced consumption of foods within this processing level. In contrast, ""use of delivery services"" (beta = 3.39), ""replacing main meals with snacks"" (beta = 5.49), ""visual appeal"" (beta = 2.17), ""social norms"" (beta = 2.19) and ""affect regulation"" (beta = 2.01) associated with increased ultraprocessed food consumption. Overall, associations were more frequent and pronounced when analyzing food consumption by processing level rather than by macronutrient intake. Conclusion: Some eating habits and food choice determinants (""snacking,"" ""replacing meals with snacks,"" ""use of delivery services"") observed during the COVID-19 pandemic were associated with an unhealthy diet (high energy and carbohydrate consumption, increased ultraprocessed food consumption and reduced unprocessed/minimally processed foods consumption) in Brazilian women.